The Acceptable Haemoglobin’s Drop after Uncomplicated Caesarean Sections

Khreisat, Basel M.; Donayeva, Ainur; Jaafar, Zainab Abdul Ameer; Shaimbetov, Zhangeldy; Abdelazim, Ibrahim A.; Sarkulova, Zhanslu; Sarkulov, Marat; Omarova, Ainur

doi:10.34763/jmotherandchild.20242801.d-24-00050

Abstract

Background

Routine haemoglobin assay is a common postoperative (PO) practice after caesarean sections (CSs). There is no consensus regarding the acceptable haemoglobin’s (Hb’s) drop after uncomplicated CSs. Objective: To detect the acceptable Hb’s drop after uncomplicated caesarean sections (CSs).

Material and Methods

Seventy-five (75) participants delivered by uncomplicated elective CSs (ECSs) were recruited for the current study. Participants’ pre-operative Hb was compared to PO-Hbs using t-test to detect the acceptable Hb’s drop after uncomplicated ECSs. Correlations between the 48-hrs. PO-Hb’s drop or 1-week PO-Hb’s drop and estimated blood loss (EBL) during uncomplicated ECSs was detected using Pearson’s correlation.

Results

Mean duration of uncomplicated ECS was 43.3 ± 1.7 min. and mean EBL during uncomplicated ECSs was 654.4 ± 54.49 ml. No significant difference was detected in this study when 48-hrs. PO-Hb (10.89 ± 0.43 gms%) or 1-week PO-Hb (10.86 ± 0.46 gms%) were compared to the participants’ pre-operative Hb (12.2 ± 0.46 gms%), (p=0.3 and 0.5, respectively).

Mean 48-hrs. and 1-week PO-Hb’s drop after uncomplicated ECSs were 1.28 ± 0.09 and 1.3 ± 0.07 gms%, respectively. The correlation between 48-hrs. PO-Hb’s drop and EBL during uncomplicated ECSs was not significant (r=−0.14; p=0.23). The correlation between 1-week PO-Hb’s drop and EBL during uncomplicated ECSs was also not significant (r=0.017; p=0.89).

Conclusions

Mean 48-hrs. and 1-week PO-Hb’s drop after uncomplicated ECSs were 1.28 ± 0.09 and 1.3 ± 0.07 gms%, respectively. Correlations between either the 48-hrs. PO-Hb’s drop or 1-week PO-Hb’s drop and EBL during uncomplicated ECSs were not significant.

References

Ramadani H. Cesarean section intraoperative blood loss and mode of placental separation. Int J Gynaecol Obstet. 2004;87(2):114–8. doi:10.1016/j.ijgo.2004.07.019.
Open DOI Search in Google Scholar Back to article
Murphy DJ, MacGregor H, Munishankar B, McLeod G. A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section-pilot study. ISRCTN 40302163. Eur J Obstet Gynecol Reprod Biol. 2009;142(1):30–3. doi:10.1016/j.ejogrb.2008.09.004.
Open DOI Search in Google Scholar Back to article
Flo K, Wilsgaard T, Vårtun A, Acharya G. A longitudinal study of the relationship between maternal cardiac output measured by impedance cardiography and uterine artery blood flow in the second half of pregnancy. BJOG. 2010;117(7):837–44. doi:10.1111/j.1471-0528.2010.02548.x.
Open DOI Search in Google Scholar Back to article
Abdelazim I, Farghali M, Amer OO. Routine hemoglobin assay after uncomplicated caesarean sections. Prz Menopauzalny. 2021;20(1):29–33. doi:10.5114/pm.2021.104474.
Open DOI Search in Google Scholar Back to article
Schorn MN. Measurement of blood loss: review of the literature. J Midwifery Womens Health. 2010;55(1):20–7. doi:10.1016/j.jmwh.2009.02.014.
Open DOI Search in Google Scholar Back to article
Lagoo J, Wilkinson J, Thacker J, Deshmukh M, Khorgade S, Bang R. Impact of anemia on surgical outcomes: innovative interventions in resource-poor settings. World J Surg. 2012;36(9):2080–9. doi:10.1007/s00268-012-1615-z.
Open DOI Search in Google Scholar Back to article
Bodur S, Gun I, Ozdamar O, Babayigit MA. Safety of uneventful cesarean section in terms of hemorrhage. Int J Clin Exp Med. 2015;8(11):21653–8.
Search in Google Scholar Back to article
Kortbeek JB, Al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, 8th edition, the evidence for change. J Trauma. 2008;64(6):1638–50. doi:10.1097/TA.0b013e3181744b03.
Open DOI Search in Google Scholar Back to article
Olieman RM, Siemonsma F, Bartens MA, Garthus-Niegel S, Scheele F, Honig A. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):195. doi:10.1186/s12884-017-1371-z.
Open DOI Search in Google Scholar Back to article
Abdelazim IA, Elbiaa AA, Al-Kadi M, Yehia AH, Nusair BM, Faza MA. Maternal and Obstetrical factors associated with successful trial of vaginal birth after caesarean section. J Turk Ger Gynecol Assoc. 2014;15(4):245–249. doi:10.5152/JTGGA.2014.14104.
Open DOI Search in Google Scholar Back to article
Sakiyeva KZ, Abdelazim IA, Farghali M, Zhumagulova SS, Dossimbetova MB, Sarsenbaev MS, et al. Outcome of the vaginal birth after cesarean section during the second birth order in West Kazakhstan. J Family Med Prim Care. 2018;7(6):1542–1547. doi:10.4103/jfmpc.jfmpc_293_18.
Open DOI Search in Google Scholar Back to article
Mathai M, Hofmeyr GJ, Mathai NE. Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev. 2013;(5):CD004453. doi:10.1002/14651858.CD004453.pub3.
Open DOI Search in Google Scholar Back to article
Walsh CA. Evidence-based cesarean technique. Curr Opin Obstet Gynecol. 2010;22(2):110–5. doi:10.1097/GCO.0b013e3283372327.
Open DOI Search in Google Scholar Back to article
Tuuli MG, Odibo AO, Fogertey P, Roehl K, Stamilio D, Macones GA. Utility of the bladder flap at cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2012;119(4):815–21. doi:10.1097/AOG.0b013e31824c0e12.
Open DOI Search in Google Scholar Back to article
Yehia AH, Koleib MH, Abdelazim IA, Atik A. Tranexamic acid reduces blood loss during and after cesarean section: a double blinded, randomized, controlled trial. Asian Pac J Reprod. 2014;3(1):53–56. doi:10.1016/S2305-0500(14)60002-6.
Open DOI Search in Google Scholar Back to article
Kathariya R, Devanoorkar A, Jain H. Intra-Operative Hemorrhage: A Review of Literature. J Med Diagn Meth. 2013;2:6.
Search in Google Scholar Back to article
Singh B, Adhikari N, Ghimire S, Dhital S. Post-operative drop in hemoglobin and need of blood transfusion in cesarean section at Dhulikhel Hospital, Kathmandu University Hospital. Kathmandu Univ Med J (KUMJ). 2013;11(42):144–6. doi:10.3126/kumj.v11i2.12490.
Open DOI Search in Google Scholar Back to article
Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR, Rhoads GG, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365(26):2453–62. doi:10.1056/NEJMoa1012452.
Open DOI Search in Google Scholar Back to article
Samaha II, Khamidullina Z, Abdelazim IA. Relationship between routine urinary catheterization and postoperative urinary symptoms and urinary tract infections in women undergoing elective caesarean section. Prz Menopauzalny. 2023;22(4):207–212. doi:10.5114/pm.2023.133847.
Open DOI Search in Google Scholar Back to article
Amanzholkyzy A, Donayeva A, Kulzhanova D, Abdelazim IA, Abilov T, Baubekov Z, et al. Relation between vitamin D and adolescents’ serum prolactin. Prz Menopauzalny. 2023;22(4):202–206. doi:10.5114/pm.2023.133883.
Open DOI Search in Google Scholar Back to article
Farghali MM, Alhadhoud FK, AlObaidly NH, Mohammad M, Abdelazim IA, Amanzholkyzy A, et al. Maternal and fetal outcomes after bariatric surgeries. Prz Menopauzalny. 2023;22(3):148–154. doi:10.5114/pm.2023.131440.
Open DOI Search in Google Scholar Back to article
Abdelazim IA, Alanwar A, Svetlana S, Kanshaiym S, Farghali M, Mohamed M, et al. Complications associated with higher order compared to lower order cesarean sections. J Matern Fetal Neonatal Med. 2020;33(14):2395–2402. doi:10.1080/14767058.2018.1551352.
Open DOI Search in Google Scholar Back to article
Bhatia M, Banerjee K, Dixit P, Dwivedi LK. Assessment of Variation in Cesarean Delivery Rates Between Public and Private Health Facilities in India From 2005 to 2016. JAMA Netw Open. 2020;3(8):e2015022. doi:10.1001/jamanetworkopen.20
Open DOI Search in Google Scholar Back to article
Rajni Mittal and Srivastava S. Estimation of Fall in Hemoglobin and Hematocrit in Uneventful Cesarean Section. International Journal of Current Advanced Research. 2019;08(01):16842–45. doi:10.24327/ijcar.2019.16845.3129.
Open DOI Search in Google Scholar Back to article